MESSAGE FROM THE PRESIDENT

Participatory Democracy

The health of a democratic society may be measured by the quality of functions performed by private citizens,” Alexis de Toqueville wrote in his landmark Democracy in America, 1835.

Even in our nascent republic, the famed French historian and political thinker was able to appreciate the importance of participatory democracy. Almost 200 years later, his conclusions may again be tested. From April 25-27, the Illinois State Medical Society (ISMS) will host the annual House of Delegates (HOD) in Oak Brook. The HOD sets policy for the organization, and is the forum for individual physicians to make their voices heard.

The Chicago Medical Society (CMS) has had strong representation at the HOD, and 2014 is following suit. By February, all 40 delegate positions had already been assigned, as well as 33 out of 40 alternate delegate seats. The CMS leadership encourages members to participate by volunteering to fill the few remaining slots.

CMS will be sponsoring several resolutions for debate at ISMS. For example, CMS has already instituted a 5% dues reduction for five-year members, and one resolution asks ISMS to match the dues reduction. There is also a CMS resolution authored by Immediate Past President Howard Axe, MD, to extend the state’s current smoking ban in public indoor places to include e-cigarettes. The ISMS Board of Trustees will be presenting a redistricting plan that purports to be more representative yet smaller in size.

Individuals and county medical societies may submit resolutions to ISMS. CMS and ISMS staff help edit the resolutions for form. The resolutions are then categorized into one of three groups for Reference Committee review:

• A: Constitution & Bylaws, Policy, Administration and Finance
• B: Healthcare Economics and Medical Legal
• C: Education & Medical Service, Governmental Affairs & Public Relations

By grouping the resolutions together, the Reference Committees have the opportunity to consider similar or redundant resolutions together.

CMS members are given the opportunity to review the resolutions several weeks in advance of the meeting. All CMS delegates and alternate delegates are part of the CMS Caucus, which will meet to discuss resolutions. The three different Resolutions Reference Committees will formally review the resolutions and make recommendations. Testimony is provided at the Reference Committees, often generating spirited and lively debate. The Reference Committees subsequently meet in private to make their recommendations for adoption, non-adoption, or modification. The full HOD is then asked to accept or reject the recommendations of the Reference Committees. Ultimately, the HOD has the authority to set policy for ISMS.

When adopted, resolutions may create new policy or an action item for the organization. Some resolutions are sent to the American Medical Association (AMA). Recently, CMS sponsored about 15 resolutions subsequently forwarded to the AMA. Kamala Ghaey, MD, authored a resolution defining obesity as a medical disease, and the AMA formalized a study on the issue. Rajeev Kumar, MD, submitted a resolution opposing Accountable Care Organization (ACO) exclusivity, and recommended allowing physicians to join multiple ACOs. The issue even reached AMA Executive Vice-President James Madara, MD, and Centers for Medicare and Medicaid Services Administrator Marilyn Tavenner.

In many ways, the ISMS House of Delegates represents the democratic highlight of the year. CMS members have answered Tocqueville’s call for participatory democracy by submitting resolutions that progress to the state and national levels.

Robert W. Panton, MD
President, Chicago Medical Society